就最佳治疗选择和最佳临床结果而言,局部晚期非小细胞肺癌仍代表“灰色地带”。的确,大多数患者可能适合接受不同结局相似的治疗,如化疗-放疗(CHT-RT)后再接受免疫治疗(IO)或手术后再接受辅助局部/全身治疗.我们报告了一例接受原发性胸外科手术的患者的临床病例,该患者通过CHT-RT-IO成功治疗了纵隔淋巴结复发。随后,发现单个脑部病变已通过单次立体定向消融放射治疗成功治疗。患者仍在随访中,她没有疾病,生活质量良好。在这份报告中,我们还对CHT-RT和IO在治疗手术后局部区域复发中的作用进行了简短回顾.还评估了IO后SABR的作用,发现它是安全和良好的耐受性。在这种特殊情况下,需要更可靠和更大的临床数据,以更好地定义全身和局部治疗组合在已经接受CHT-RT随后接受免疫治疗的患者的胸腔内和颅内复发管理中的作用。
Locally advanced non-small-cell lung cancer still represents a \"grey zone\" in terms of the best treatment choice and optimal clinical outcomes. Indeed, most patients may be suitable to receive different treatments with similar outcomes such as chemo-radiotherapy (CHT-RT) followed by immunotherapy (IO) or surgery followed by adjuvant local/systemic therapies. We report a clinical
case of a patient submitted to primary thoracic surgery who developed a mediastinal nodal recurrence successfully treated by CHT-RT-IO. Subsequently, a single brain lesion was found to have been successfully treated by single fraction stereotactic ablative radiotherapy. The patient is still on follow-up and she is free from disease having a good quality of life. In this report, we also perform a mini review about the role of CHT-RT followed by IO in treating loco-regional relapse after surgery. The role of
SABR after IO is also evaluated, finding that it is safe and well tolerated. More robust and larger clinical data are needed in this particular setting to better define the role of the combination of systemic and local treatments in the management of intrathoracic and intracranial relapse for patients already submitted to CHT-RT followed by immunotherapy.